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NOTICE OF COMPLIANCE <br />CITY "A ,AFF. I1111RINT I'III I III°i I1111AG➢E AND INCLUDE CE I 1111 AGR E➢E k1➢EN I TO 1111I E CLERIC CSC 1111I E COUNCIL <br />L <br />Contractor Palacios Law Office <br />Name: <br />Project N-2022-334 <br />Number: <br />Project City Of Santa Ana Agreement With Palacios Law Office To Provide <br />Name: Administrative Hearing Services <br />The Certificate of Insurance (COI) submitted indicates that the coverages are in compliance with the <br />insurance requirements. No further action is required at this time. <br />The compliant coverage(s) are: <br />EXPIRATION <br />TYPE OF INSURANCE <br />POLICY NUMBER <br />COI DATE <br />FILE NAME <br />DATE <br />........................................................ <br />General Liability <br />AUTOMOBILE LIABILITY <br />65SBMTH3424 <br />06/28/2024 <br />06/22/2023 <br />Certificate 2023- <br />2024 22 JUN <br />2023. Pdf <br />General Liability <br />GENERAL LIABILITY <br />65SBMTH3424 <br />06/28/2024 <br />06/22/2023 <br />Certificate 2023- <br />2024 22 JUN <br />2023. Pdf <br />PROFESSIONAL LIABILITY <br />JQF1803079 <br />02/01/2024 <br />02/06/2023 <br />Palacios cert <br />Santa Ana.pdf <br />Workers Comp <br />WORKERS COMPENSATION EXEMPTION <br />WAIVER <br />11/01/2024 <br />11/01/2023 <br />Waiver 2023- <br />2024.pdf <br />Thank you, <br />City of Santa Ana <br />Risk Management Division <br />in partnership with <br />CTrax Plus Services Team <br />11/3/2023 5:03 PM <br />